2. Marco teórico
2.2. Marco referencial
2.2.1. Generalidades del Campo Shushufindi - Aguarico
Introduction
1. A key priority for DSP is to ensure that fraudulent activity within the social welfare system is vigorously prevented and combated. Fraud undermines public confidence in the entire system as well as being unfair to other recipients of social welfare payments and taxpayers. The control principles underpinning DSP‟s overall approach in this regard include prevention, detection, deterrence, recovery/debt management, and measuring outcomes (more details below).
2. The Programme for Government contains a number of commitments in relation to Social Welfare fraud, including:
“A zero tolerance approach to welfare fraud will be underpinned by a major anti-
fraud enforcement drive;
A range of measures to tackle the problem of welfare fraud, including a “one-stop
shop” Payments and Entitlements Service will be created to process all major welfare and other entitlements;
More regular face-to-face interviews with an integrated employment and entitlements
service for those of working age, and;
Additional anti-fraud measures using latest available technology and better sharing
of data across government Departments and agencies”.
3. Following the reorganisation of Departmental responsibilities announced in 2010, DSP now has a much wider role in relation to the provision of activation, employment, and community services and income support. The transfer of functions brings together employment supports and associated income support services into one organisation.
4. The addition of some 1,700 Community Welfare Service (CWS) and FÁS staff, together with responsibility for a wide range of activation programmes at local level, will enhance DSP‟s ability to interact directly with clients of working age in more effective and innovative ways. This will be achieved in the context of a new service vision and model that provides personalised assistance and co-ordinated/integrated service delivery. Arising from this transfer a more integrated approach to control can now be realised. This will include the creation of a single client view for control purposes.
Current Control Strategy
5. DSP processes in excess of two million claims each year and it makes payments to approximately 1.43 million people every week It is important to emphasise that the vast majority of people are receiving the entitlement due to them.
6. The emphasis in the current control strategy is to minimise risks of fraud and eliminate incorrect payments. Ensuring that the right person is paid the right amount of money at the
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right time is an integral part of the day-to-day work of DSP and every staff member in DSP is responsible for the prevention of fraud and error.
7. The current approach adopted to control fraud and abuse of schemes can be summarised as follows:
Prevention - having systems and procedures in place that prevent and minimise the
risk of fraud, abuse and error;
Detection - detecting fraud, abuse and errors at the earliest possible stage, and
detecting unpaid Pay-Related Social Insurance (PRSI) contributions by employers and the self-employed;
Deterrence – to develop an anti-fraud culture among staff and the public by ensuring
that the public is aware of the risks and penalties of defrauding the Social Welfare system and dealing decisively with cases of fraud and abuse detected; and
Debt Recovery – to actively pursue the recovery of all debts.
Forthcoming Control Plan
8. DSP‟s control strategy is currently being updated and enhanced, in the light of the Government commitments outlined above, and the necessity for significant ongoing expenditure control. This update will form the basis for a revised and renewed approach to the challenges posed by social welfare fraud and will help to ensure that scarce resources are utilised for the protection of those who have genuine need and entitlement. The objectives of the new strategy are designed:
To ensure an integrated approach to the prevention, deterrence, detection of social
welfare abuse across the social welfare system. Where social welfare fraud occurs to develop DSP capabilities to identify and stop it as soon as possible;
To work closely and collaboratively with other agencies to ensure that Social Welfare
abuse is comprehensively deterred and detected;
To police actively the hidden economy and those sectors where there is a prevalence
of social welfare fraud and abuse;
Where fraud is detected there must be appropriate sanctions and penalties applied so
as to promote public confidence in the social welfare system. The new strategy is about reinforcing the rights and responsibilities of clients as well as improving public perceptions about the security of the social welfare system;
Where social welfare fraud is committed, the effective and timely recovery of
associated overpayments is imperative; and
A system for the oversight and measurement of fraud control activity will be put in
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What will be different on foot of the new Control Plan?
9. The following is a summary of the enhancements being progressed or considered in 2011 and 2012 and these are detailed further in this chapter.
Build on current control core activities but „work smarter‟ by better targeting based
on risk and being more agile.
Refocus from claims processing to control activities while bearing in mind the need
for balance.
Start the roll out of Public Service Card in autumn 2011 to help tackle identity fraud.
Arising from the transfer of the Community Welfare Service and FÁS to DSP, realise
a more integrated approach to fraud control through creating a single client view.
Local Area Activation and Control teams to be established in all Local Office areas
Explore other data matches and assess on a VFM basis.
SIU to concentrate more on more high end work.
More timely fraud and error surveys to improve targeting.
Enhanced recovery of over payments. Over the coming months, various options to
developing a more active debt recovery approach will also be explored.
Enhanced use of technology.
Legislative amendments.
Increased penalties for those operating in the shadow economy.
10. The new strategy, especially in the current climate and given public concern generally, takes a revised and renewed approach to the challenges posed by social welfare fraud. The ambition is to ensure that DSP‟s approach to social welfare fraud is seen as tough but fair - with appropriate sanctions in place to those who perpetrate fraud. Finally, the strategy is designed to ensure that the public have confidence in Government‟s response to combating fraud in the social welfare system.
11. Finalising the new strategy is a priority action for DSP and it will be launched by Minister Burton in September 2011. Briefing and feedback on the new Control Plan was also obtained by senior management in August 2011 in the context of a series of 8 regional seminars involving staff in the investigation related areas. The objective is to re-emphasise the importance of this work in DSP and to increase awareness and commitment of all those involved.
Social Welfare Fraud and Abuse
12. The principal ways in which social welfare payments are claimed fraudulently are:
Concurrent Working and Claiming: Where a person claims a payment, such as
Jobseeker‟s Benefit / Allowance or an illness payment, but takes up employment and does not notify DSP. The fact that people can, in certain circumstances, legitimately work and claim a payment increases the perception of fraud among the public. This is difficult for DSP to address.
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Non-disclosure of Means: Where a person claims a means tested payment, for
example Jobseeker‟s Allowance, Disability Allowance or One-Parent Family Payment, but they do not fully disclose their means to DSP.
Non residency in the State: Where a person claims a social welfare payment, such as
a jobseeker‟s or a One-Parent family payment and is not resident in this jurisdiction, without notifying DSP but continues to claim the payment.
Cross Jurisdictional Claiming: Where a person claims a social welfare payment in
Ireland but also makes or continues a claim in another country e.g. NI or the UK.
Multiple claiming or Personation: Where a person makes a claim for more than one
social welfare payment by assuming and falsely using the identity and PPSN of another person.
Life Events: Where a person continues to claim a payment to which they are no
longer entitled such as a lone parent who gets married or someone who continues to Carer‟s Allowance claim where caring duties have ceased.
Co-habitation: In the case of One-Parent family payments, persons may be living as
a „family unit‟ and fail to notify to DSP of the situation.
Social Insurance and Employer Non Compliance: Where employers fail to
maintain appropriate employment/wage records and where non-compliance or non- remittance of Pay Related Social Insurance occurs.
Current Control Measures to address Fraud and Abuse
13. Standard measures to control fraud and abuse in these areas include desk reviews of claim papers, home visits, the issue of mail-shots to selected clients, database checking, medical reviews in the case of illness payments etc. Controls are exercised at both the initial claim stage and at subsequent stages during the claim life cycle. Claims are reviewed on a regular and targeted basis. Means tested payments are reviewed at certain intervals or when there are indications that changes in circumstances have not been reported to DSP. Those in receipt of illness payments are called for a medical examination by DSP‟s Medical Assessors. Clients in receipt of unemployment payments are checked on an ongoing basis to verify continued compliance with such requirements as being available for and genuinely seeking employment.
14. DSP also has a programme of employer inspections to ensure that accurate records of employees are kept; the correct class of PRSI is being deducted and remitted, employees are not concurrently working and claiming social welfare payments and that employers are aware of their responsibilities with regard to social welfare and tax legislation and incentives available to employers.
15. DSP accepts that there is scope to „work smarter‟ in these standard investigative areas e.g. by better targeting. Other initiatives along these lines include:
59 Data Matching
16. DSP has in the last number of years been engaged in data matching with other Government Departments and public bodies for control purposes. Data matching is viewed as a very efficient and effective mechanism to target control–related activity. Examples of data matching for control purposes include:
Irish Prison Service: Weekly data matches are performed to identify cases where
inmates are receiving a payment from DSP /HSE while in custody.
Education: third level institutions/colleges supply DSP with details of students
registered for full-time day courses of education, including Post Leaving Certificate courses.
General Register Office (GRO): provides birth, marriage and death data.
Revenue Commissioners: Commencement of employment notifications are received
on a systematic basis and are used to ensure no concurrent working and claiming of benefits or allowances have occurred.
Other matches which have been undertaken include data held by the Personal Injuries
Assessment Board, Commission for Taxi Regulation and Private Residential Tenancies Board.
Fraud and Error Surveys
17. These surveys are deliberately undertaken in high risk schemes and assist the DSP in better targeting its control resources. More details are given later in this chapter.
Activation and Control Teams
18. As part of the new Control Plan and in order to ensure an integrated approach to fraud control, Activation and Control Teams will be established across DSP‟s Regional network in each Local Office area. These control teams will be comprised of Social Welfare Inspectors, Special Investigation Unit staff, Community Welfare Officers, FÁS and Social Welfare Local Office staff. They will help to ensure that all control activities, established and new, are being vigorously applied and augment them with targeted specific approaches, based on local knowledge and circumstances.
Identity and Payment Checks
19. New claimants for jobseeker‟s payments are now exclusively paid through post offices. This requires them to attend the post office each week thus confirming their residency in the country. Photographic identification is also required when collecting payments at the post office. DSP has commenced the roll out of stronger identity checks including storage of photographs.
Reviews of Entitlement
20. These are systematically undertaken across all social welfare schemes having regard to the level of fraud risk associated with these schemes. Over 900,000 individual social welfare claims were reviewed in 2010.
60 Direct Mailshots
21. DSP supplements reviews of entitlement by the frequent use of direct mailshots to validate with clients that the conditions for receipt of benefits, allowances and child related payments are met.
Medical Eligibility Assessments
22. In the case of persons receiving illness and disability payments, recipients are reviewed on a systematic basis through medical assessments and examinations to ensure that the medical eligibility entitlement is still fulfilled.
Non Residency Checks
23. Residency checks on social welfare claims by non-Irish nationals are undertaken nationwide by Departmental Inspectors in order to determine whether their residency status in the State is fulfilled. The frequency of the visits is varied so as not to establish a predictable pattern. Reporting of Social Welfare Fraud
24. Reports of suspected fraudulent social welfare claims can be made by telephone to Central Control Unit or any DSP office. Alternatively, there is an on-line facility for members of the public to report their suspicions of social welfare fraud on www.welfare.ie. Members of the public are asked to provide as much detail about the case they are reporting as possible and with these facilities they can do so totally anonymously. The facility for the public to report suspected social welfare fraud on-line is the most frequently used method of reporting. In 2010, 59% of reports were received on-line. In 2011 (first quarter) 69% of reports were received on-line.
Strategic co-operation with the Revenue Commissioners
25. A High Level Group comprising senior representatives of DSP and Revenue are working together with a view to aligning expertise and information across the operations of both organisations. Minister Burton addressed the May 2011 meeting of this Group.
Legal Proceedings and Prosecution
26. It is DSP policy to consider for prosecution all cases of welfare fraud. Criminal prosecutions are taken in the main by summary proceedings in the District Courts. The maximum penalty provided for cases taken summarily is a fine not exceeding €2,500 or a term of imprisonment
not exceeding six months or both such fine and imprisonment - increased from €1,500 on 4th
January 2011. Criminal prosecutions may be taken against persons who defraud the social welfare payments system and employers who fail to carry out their statutory obligations. Multi Agency Vehicle Checkpoints
27. DSP is involved in the multi-agency vehicle checkpoints (MAVCs) with other agencies, including the Gardaí, Traffic Corps and Revenue Commissioners. Each agency has specific control and compliance briefs. The other agencies involved are fully aware of the priority and importance accorded by DSP to cross-border claiming and it forms an integral part of this combined operation.
61 Cross-Border Operational Forum
28. The Cross-Border Operational Forum comprises of selected investigators from DSP, the UK Department for Work and Pensions and the Northern Ireland Social Security Agency of the Department for Social Development (DSD). The Forum‟s remit is to liaise at an operational level, under the aegis of the Memorandum of Understanding between the three Governments concerning matters of mutual interest in the areas of fraud in their respective social security systems.
Exchange of Data between jurisdictions
29. Case by case data-matching takes places between DSP and the DSD in Northern Ireland and the DWP in the UK on cases where social welfare fraud or abuse is occurring.
Debt Management
30. DSP actively pursues the recovery of debts to maximise recovery levels with due regard to value for money and with particular emphasis on recovery from people no longer dependent on social welfare payments.
Public Service Card
31. The new PSC will include a photograph and signature. One of the anticipated advantages of the new card when fully rolled out is that it will help to reduce fraud and error which result from the incorrect identification of benefit (more details below).
Special Investigation Unit
32. The function of DSP‟s Special Investigation Unit (SIU) is to investigate and report on fraud and abuse of social welfare schemes. The Unit‟s exclusive function is that of fraud investigation. In the context of the new Control Plan, the Unit will:
Conduct comprehensive investigations where the risk of concurrent working and
claiming social welfare payments is most prevalent;
Undertake a series of targeted national projects aimed at the prevention and detection
of social welfare fraud in high risk sectors, schemes and client cohorts; and
Work closely and collaboratively with other compliance and fraud investigation
agencies to ensure that Social Welfare abuse is comprehensively deterred and detected (i.e. Revenue, NERA, and An Garda Síochána).
33. The SIU operates at the cutting edge of fraud. Joint operations have been undertaken in the following sectors thus far in 2011 between DSP and Revenue. The list is not exhaustive but rather illustrative of the sectors being jointly policed:
i. A series of joint operations across all Regions have been conducted on once off builds (construction sites);
ii. A series of joint operations have been conducted in ethnic restaurants catering and fast food sectors;
iii. A JIU operation at a newly completed hospice was carried out in March targeting a team of contract cleaners;
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iv. Reliable „good citizen‟ reports on employers and sectors that are received by DSP‟s Control hotline are generally dealt with by way of JIU operation;
v. A JIU operation conducted related to a sex shop business where Revenue were interested in the cash flow of the business and the combined powers of Revenue/DSP were used to good effect;
vi. A total of 11 high profile JIU/Taxi Regulator Operations have been carried out involving JIU/Revenue/GNIB/Traffic Corps at night in Cork, Galway, Roscommon, Limerick, Shannon Airport and Dublin;
vii. JIU high profile operations have been carried out with the Environmental Section of Cork County Council/DSP and Revenue targeting scrap dealers and illegal dumpers
viii. JIU‟s operated bilateral Multi Agency Vehicle Checkpoints in the Southern, Western Border and Border Midlands Regions;
ix. SIU officers have participated in streetscape projects with Revenue in certain Regions. These operations involve visits to all employers in a specific town or location to test and check compliance;
x. A major joint investigation was concluded in the Mid West on distribution centres resulting in social welfare fraud detections, new tax registrations and undisclosed VAT liabilities;
xi. A joint DSP / Revenue / Garda National Immigration Bureau investigation was undertaken and is ongoing with regard to a major player in the clothes recycling sector; and
xii. A high visibility multi agency operation led by An Garda Síochána involving both
DSP and Revenue was conducted at the Smithfield Horse Fair on 1st May and 5th
June 2011.
Value of Control Work in DSP and Control Targets
34. Control savings arise as a result of control activity on claims in payment and from inspections of employers, as detailed above. These activities also have deterrent or knock-on